A Case Study in Ditching Diet Culture
Throughout the past few months, nutritionist Michelle Ritter, MS, RDN, NASM L1 CPT has shared a number of videos on our YouTube channel about intuitive eating. As a reminder, intuitive eating is a non-diet approach with an evidence-based framework for healing your relationship to food and your body. As she explains in a previous video and blog post, “The hope is to learn and understand that we can have a productive, meaningful, and more authentic relationship to food.”
A Recent Case Study
In a recent video for her series on intuitive eating, Michelle discusses a case study about a patient at The Kahm Clinic. In the beginning, this individual focused on healthy eating with the hope of losing weight. However, as she continued her journey, she adopted diet culture thinking and began to feel stuck in her unhealthy habits.
Her testing results supported this feeling. Her metabolism — the fire that keeps the systems and functions in your body running — had dropped significantly. As Michelle explains, “When your metabolism starts to drop, it means that your body can’t do the work that it’s intended to do in order to keep you healthy.” When you diet, your metabolism slows down as a way for the body to cope with less eating and less fuel (calories). This individual had been dieting and under-eating for so long that her body had slowed down to 38 percent of her predicted metabolic rate, which is quite substantial.
Additionally, this person’s protein substrate — how much your body breaks down the healthy tissue like muscle and lean mass to use it as energy — was quite high at three times the normal breakdown. Essentially, because her incoming calories weren’t enough, the body needed to rely on healthy tissue in order to get her through the day.
In addition to her under-eating, this individual experienced some other food-related issues, including:
Obsession with weighing and measuring every incoming calorie
High level of food fears, including fear of carbohydrates, fats, eating too many foods at a single meal, and eating the same food multiple times per day
No hunger or appetite cues
Over-hydration in an effort to suppress hunger signals
Daily digestive discomfort, including gas, bloating, and nausea
A rigid exercise routine of six days per week
Ultimately, this patient was eating only 51 percent of her nutritional needs, which explains both her low metabolism and her high protein substrate. These results helped the individual see that her dieting caused numerous unhealthy side effects. In response, she really committed to ditching diet culture over the next six months.
The Results of Ditching Diet Culture
To start, we developed a prescriptive meal plan to coach the patient back into healthy eating patterns. Then, we moved into intuitive eating and really shifted our focus to a premise of ditching diet culture.
This individual learned to truly trust the process and saw great results because of it. In six months, her metabolism improved to 110 percent of the predicted rate, and her protein substrate was within a normal range. She ate 100 percent of her daily nutritional needs and stopped some unhealthy habits, like measuring food or eliminating all carbohydrates. Additionally, her hunger cues returned, and her digestive symptoms completely resolved. Finally, she stopped weighing herself, and, as a result, she stopped fixating on how she felt about her body. As Michelle says, “She challenged herself in really important ways and felt a lot of liberation and freedom because of it.”
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